Individual
DENA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6000
(860) 358-6071
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
232210
NY
2085R0202X
Diagnostic Radiology Physician
Primary
38133
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001381334
—
CT
05
—
02883136
—
NY
01
—
A400154401
MEDICARE PTAN
NY
Enumeration date
06/07/2006
Last updated
05/28/2024
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